Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico
Summary: Background: Cirrhosis is a public health threat associated with high mortality. Alcoholic Liver Disease (ALD) is the leading cause in Latin America and Metabolic Associated Fatty Liver Disease (MAFLD) in western countries. In Mexico, ALD and chronic Hepatitis C Virus infection (HCV) were t...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X21001472 |
| _version_ | 1819364942411726848 |
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| author | Alex Gonzalez-Chagolla Antonio Olivas-Martinez Jesus Ruiz-Manriquez Maximiliano Servín-Rojas Eric Kauffman-Ortega Luis Carlos Chávez-García Oscar Juárez-León Jacqueline Cordova-Gallardo Juan Daniel Díaz-García Maria Sarai Gonzalez-Huezo Guadalupe Milanés-Lizarraga Victor M Paez-Zayas Mauricio Castillo-Barradas Orestes de Jesús Cobos-Quevedo Francisco Isaí García-Juárez José Alberto Romero-Lozanía Liz Toapanta-Yanchapaxi Juan Francisco Sánchez-Avila José Alonso Avila-Rojo Aliberth Bonilla-Salas Michelle Dirthurbide-Hernández Isaac Ruiz Ana K. Valenzuela-Vidales Ignacio García-Juárez |
| author_facet | Alex Gonzalez-Chagolla Antonio Olivas-Martinez Jesus Ruiz-Manriquez Maximiliano Servín-Rojas Eric Kauffman-Ortega Luis Carlos Chávez-García Oscar Juárez-León Jacqueline Cordova-Gallardo Juan Daniel Díaz-García Maria Sarai Gonzalez-Huezo Guadalupe Milanés-Lizarraga Victor M Paez-Zayas Mauricio Castillo-Barradas Orestes de Jesús Cobos-Quevedo Francisco Isaí García-Juárez José Alberto Romero-Lozanía Liz Toapanta-Yanchapaxi Juan Francisco Sánchez-Avila José Alonso Avila-Rojo Aliberth Bonilla-Salas Michelle Dirthurbide-Hernández Isaac Ruiz Ana K. Valenzuela-Vidales Ignacio García-Juárez |
| author_sort | Alex Gonzalez-Chagolla |
| collection | DOAJ |
| description | Summary: Background: Cirrhosis is a public health threat associated with high mortality. Alcoholic Liver Disease (ALD) is the leading cause in Latin America and Metabolic Associated Fatty Liver Disease (MAFLD) in western countries. In Mexico, ALD and chronic Hepatitis C Virus infection (HCV) were the most frequent aetiologies during the past decades. We aimed to describe the trends in the aetiologies of cirrhosis in a middle-income country. Methods: We performed a retrospective cohort study including patients diagnosed with cirrhosis between 2000 and 2019 from six different tertiary care hospitals in central Mexico. We collected information regarding cirrhosis etiology, year of diagnosis, hepatocellular carcinoma development, liver transplantation, and death. We illustrated the change in the tendencies of cirrhosis aetiologies by displaying the proportional incidence of each etiology over time stratified by age and gender, and we compared these proportions over time using chi square tests. Findings: Overall, 4,584 patients were included. In 2019, MAFLD was the most frequent cirrhosis etiology (30%), followed by ALD (24%) and HCV (23%). During the study period, MAFLD became the leading etiology, ALD remained second, and HCV passed from first to fourth. When analysed by gender, ALD was the leading etiology for men and MAFLD for women. The annual incidence of HCC was 3·84 cases/100 persons-year, the median survival after diagnosis was 12·1 years, and seven percent underwent LT. Interpretation: Increased alcohol consumption and the obesity epidemic have caused a transition in the aetiologies of cirrhosis in Mexico. Public health policies must be tailored accordingly to mitigate the burden of alcohol and metabolic conditions in developing countries. Funding: None. |
| first_indexed | 2024-12-24T23:06:57Z |
| format | Article |
| id | doaj.art-a7a81e3400bf4f369022ef479cb29e1a |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-12-24T23:06:57Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-a7a81e3400bf4f369022ef479cb29e1a2022-12-21T16:35:01ZengElsevierThe Lancet Regional Health. Americas2667-193X2022-03-017100151Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central MexicoAlex Gonzalez-Chagolla0Antonio Olivas-Martinez1Jesus Ruiz-Manriquez2Maximiliano Servín-Rojas3Eric Kauffman-Ortega4Luis Carlos Chávez-García5Oscar Juárez-León6Jacqueline Cordova-Gallardo7Juan Daniel Díaz-García8Maria Sarai Gonzalez-Huezo9Guadalupe Milanés-Lizarraga10Victor M Paez-Zayas11Mauricio Castillo-Barradas12Orestes de Jesús Cobos-Quevedo13Francisco Isaí García-Juárez14José Alberto Romero-Lozanía15Liz Toapanta-Yanchapaxi16Juan Francisco Sánchez-Avila17José Alonso Avila-Rojo18Aliberth Bonilla-Salas19Michelle Dirthurbide-Hernández20Isaac Ruiz21Ana K. Valenzuela-Vidales22Ignacio García-Juárez23Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Biostatistics, University of Washington, Seattle, WA, United StatesDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoLiver transplant unit and department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, colonia Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, MexicoDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoHepatology clinic, Department of Surgery, Hospital General Dr Manuel Gea Gonzalez, Mexico City, MexicoDepartment of Internal Medicine, Hospital General Dr Manuel Gea Gonzalez,Mexico City, MexicoDepartment of Gastroenterology, Centro Médico ISSEMYM, Toluca, State of Mexico, MexicoDepartment of Gastroenterology, Centro Médico ISSEMYM, Toluca, State of Mexico, MexicoOrgan Transplant Department, Hospital General de Mexico Doctor Eduardo Liceaga, Mexico City, MexicoDepartment of Gastroenterology, Hospital de Especialidades Dr Antonio Fraga Mouret Centro Médico Nacional La Raza IMSS, Mexico City, MexicoDepartment of Gastroenterology, Hospital de Especialidades Dr Antonio Fraga Mouret Centro Médico Nacional La Raza IMSS, Mexico City, MexicoDepartment of Gastroenterology. Hospital Regional Licenciado Adolfo López Mateos, Mexico City, MexicoDepartment of Gastroenterology. Hospital Regional Licenciado Adolfo López Mateos, Mexico City, MexicoNeuromuscular Disease Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoEscuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Nuevo León, MexicoDepartment of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoSchool of Medicine, Universidad Autónoma del Estado de Morelos, Morelos, MexicoDepartment of Hepatology and Liver Transplantation, Centre Hospitalier de l'Université de Montréal (CHUM), Canada; Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955 Team 18, Hôpital Henri Mondor, Université Paris-Est, Créteil, FranceDepartment of Hematology-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoLiver transplant unit and department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, colonia Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico; Corresponding author.Summary: Background: Cirrhosis is a public health threat associated with high mortality. Alcoholic Liver Disease (ALD) is the leading cause in Latin America and Metabolic Associated Fatty Liver Disease (MAFLD) in western countries. In Mexico, ALD and chronic Hepatitis C Virus infection (HCV) were the most frequent aetiologies during the past decades. We aimed to describe the trends in the aetiologies of cirrhosis in a middle-income country. Methods: We performed a retrospective cohort study including patients diagnosed with cirrhosis between 2000 and 2019 from six different tertiary care hospitals in central Mexico. We collected information regarding cirrhosis etiology, year of diagnosis, hepatocellular carcinoma development, liver transplantation, and death. We illustrated the change in the tendencies of cirrhosis aetiologies by displaying the proportional incidence of each etiology over time stratified by age and gender, and we compared these proportions over time using chi square tests. Findings: Overall, 4,584 patients were included. In 2019, MAFLD was the most frequent cirrhosis etiology (30%), followed by ALD (24%) and HCV (23%). During the study period, MAFLD became the leading etiology, ALD remained second, and HCV passed from first to fourth. When analysed by gender, ALD was the leading etiology for men and MAFLD for women. The annual incidence of HCC was 3·84 cases/100 persons-year, the median survival after diagnosis was 12·1 years, and seven percent underwent LT. Interpretation: Increased alcohol consumption and the obesity epidemic have caused a transition in the aetiologies of cirrhosis in Mexico. Public health policies must be tailored accordingly to mitigate the burden of alcohol and metabolic conditions in developing countries. Funding: None.http://www.sciencedirect.com/science/article/pii/S2667193X21001472CirrhosisMAFLDHepatocellular carcinomaHepatitis C VirusAlcohol liver diseaseLiver transplantation |
| spellingShingle | Alex Gonzalez-Chagolla Antonio Olivas-Martinez Jesus Ruiz-Manriquez Maximiliano Servín-Rojas Eric Kauffman-Ortega Luis Carlos Chávez-García Oscar Juárez-León Jacqueline Cordova-Gallardo Juan Daniel Díaz-García Maria Sarai Gonzalez-Huezo Guadalupe Milanés-Lizarraga Victor M Paez-Zayas Mauricio Castillo-Barradas Orestes de Jesús Cobos-Quevedo Francisco Isaí García-Juárez José Alberto Romero-Lozanía Liz Toapanta-Yanchapaxi Juan Francisco Sánchez-Avila José Alonso Avila-Rojo Aliberth Bonilla-Salas Michelle Dirthurbide-Hernández Isaac Ruiz Ana K. Valenzuela-Vidales Ignacio García-Juárez Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico The Lancet Regional Health. Americas Cirrhosis MAFLD Hepatocellular carcinoma Hepatitis C Virus Alcohol liver disease Liver transplantation |
| title | Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico |
| title_full | Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico |
| title_fullStr | Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico |
| title_full_unstemmed | Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico |
| title_short | Cirrhosis etiology trends in developing countries: Transition from infectious to metabolic conditions. Report from a multicentric cohort in central Mexico |
| title_sort | cirrhosis etiology trends in developing countries transition from infectious to metabolic conditions report from a multicentric cohort in central mexico |
| topic | Cirrhosis MAFLD Hepatocellular carcinoma Hepatitis C Virus Alcohol liver disease Liver transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X21001472 |
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